Medication reviews aren’t just for older patients. Changing patterns of medicine use means more young Australians need them too.
Medication reviews have traditionally centred on older patients, including those managing multiple chronic conditions, or younger patients with significant mental health needs or intellectual disability. That is now changing, with younger Australians now increasingly requiring complex medicines regimens, which may include Schedule 8 drugs.
Adult ADHD medicine use in Australia has risen sharply, with Pharmaceutical Benefits Scheme (PBS) analysis showing an increase from 0.35% of adults in 2016–17 to 2.36% in 2025 – with use higher among younger adults than older age groups.¹ These medicines are not benign, with psychostimulants associated with cardiac effects such as elevated heart rate and blood pressure, appetite suppression and weight loss, sleep disturbance, and psychiatric symptoms such as worsening mood or anxiety.²
Glucagon-like peptide-1 receptor agonist (GLP-1 RA) use has also accelerated, with researchers reporting total monthly sales in Australia rising from about 58,000 units in May 2020 to almost 500,000 in April 2025 – with an estimated 43.8% of use accessed privately.³ Because GLP-1 RAs may be prescribed outside the PBS-subsidised pathway, pharmacists may have less visibility of a patient’s broader prescribing and treatment history.
As more younger adults are prescribed these medicines – often alongside treatment for mental health, metabolic or cardiovascular conditions – they accumulate polypharmacy and adverse effect risks that give rise to the drug-related problems Home Medicines Reviews (HMRs) exist to identify and resolve. Supporting younger patients requires pharmacists to be across different life-stage factors to those typically dominating medication reviews, including nutritional requirements. The following case studies illustrate how pharmacists can use medication reviews to support younger patients navigating ADHD and GLP-1 RA treatment.
Case 1
Susan Nguyen MPS
Credentialed Pharmacist, Carmen Drive Community Pharmacy, Sydney NSW
Mrs J, 34, an administration officer and mother of two with inattentive ADHD, was referred for an ADHD Medication Review, which I provide to help patients understand their medicines, manage adverse effects and monitor the progress of their treatment. She reported worsening forgetfulness and concentration despite previously good control.
Mrs J was also experiencing new fatigue despite adequate sleep, and breathlessness on her usual morning walks.
Mrs J’s medicines included:
- lisdexamfetamine 50 mg daily (recently increased from 40 mg)
- pantoprazole 20 mg daily
- oral iron supplements, self-discontinued 3 months ago (following an iron infusion 18 months prior).
Mrs J’s medical history includes:
- inattentive ADHD
- gastro-oesophageal reflux disease (GORD)
- history of iron deficiency requiring infusion.
Her relevant history included regular but heavy periods (1–2 days). Her diet is erratic, including skipped breakfasts, quick lunches, and arriving home ‘starving’ before dinner – filling the gaps between meals with chocolate. This pattern raised the possibility that recurrent iron deficiency may be contributing to her worsening ADHD symptoms.
I recommended Mrs J see her GP for repeat iron studies – ferritin, transferrin saturation and a full blood count, rather than haemoglobin alone – before adjusting medicine doses.
I counselled her on how to best take iron supplements going forward: on an empty stomach or before meals where tolerated, since food, calcium and polyphenols can blunt absorption. Vitamin C can also modestly aid absorption by helping convert dietary ferric iron to the more readily absorbed ferrous form. I advised her to separate iron dosing from tea, coffee and certain antacids, which bind iron and reduce uptake. I further flagged that her long-term pantoprazole use was also a possible compounding factor – PPIs lower gastric acidity, which is needed to solubilise and absorb dietary and supplemental iron.
We discussed nutrition’s broader role in ADHD. Protein supports dopamine and noradrenaline production, and deficiencies in iron, zinc, vitamin D, magnesium and omega-3s are linked to greater symptom severity. I was careful not to simply hand over a meal plan. ADHD creates barriers to eating well: food aversions; hyperfocus that overrides awareness of mealtimes; executive dysfunction that makes meal planning harder; emotional dysregulation that drives impulsive eating; and reduced interoception, meaning hunger and fullness can be missed. For Mrs J, the barrier wasn’t nutrition knowledge – evident in how well she feeds her family – but time, workload and competing mental load. This meant the advice provided needed to fit around her day.
Key practice points for ADHD medicines management
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Provided by Susan Nguyen MPS
Case 2
Mitchell Everlyn MPS
Consultant Pharmacist, Brisbane Queensland
Ms K, 30, was referred for a Home Medicines Review for polypharmacy, management of her comorbidities and to support long-term weight loss following her recent start on tirzepatide. Her GP’s referral reflected an increasingly familiar picture: obesity, type 2 diabetes, hypertension, and a history of depression and anxiety, now layered with a new GLP-1 RA.
Ms K’s medicines included:
- tirzepatide 10 mg weekly (25-click dose)
- lamotrigine (Lamictal) 200 mg tablets, ½ tablet (100 mg) at night
- rosuvastatin 5 mg at night
- guanfacine 2 mg at night
- bupropion 150 mg each morning
- esomeprazole 40 mg
- propranolol 40 mg twice daily, for anxiety and hypertension
- Movicol, 1 sachet at night.
Ms K’s medical history includes:
- obesity (BMI >35m²)
- type 2 diabetes (HbA1c 7.1%)
- hypertension
- anxiety and depression.
As with any patient commencing a GLP-1 RA, I checked how her weight, HbA1c, renal function and gastrointestinal tolerance were being monitored, alongside blood pressure – seated and standing, given her antihypertensive therapy. Diabetes, obesity and depression share a well-recognised bidirectional relationship, with each capable of worsening the other, so mood was on my checklist from the outset rather than an afterthought.
During the consultation, we covered her weight loss goals, diet and possible nutritional deficiencies, acute and chronic management of constipation, and correct administration of the GLP-1 RA injection.
I also talked her through tirzepatide’s adverse effects, particularly how nausea and lack of appetite can affect nutritional intake. Given her history of mental health and limited access to her GP, as a patient in a rural area, I made sure that this review did double duty as an education session. My recommendations were to refer Ms K to a dietitian for dietary support and to her psychologist for review, and to start acute and chronic constipation management alongside her current medicines. We then discussed the relationship between food and mood – how high-sugar foods like chocolate give an initial dopamine spike, while foods that are high in protein and have a low glycemic index support mood over time without that spike.
I also asked Ms K’s GP to monitor her weight, dietary deficiencies and constipation as well as mood, given her history of anxiety and depression.
References
- UNSW Sydney. New data shows sharp rise in adult ADHD medication use. Apr 2026. At: www.unsw.edu.au/news/2026/04/new-data-shows-sharp-rise-in-adult-adhd-medication-use
- Suetani S, Hull J, Scott JG. Pharmacological management of attention deficit hyperactivity disorder in adults. Aust Prescr 2026;49(1):10–5. At: https://australianprescriber.tg.org.au/articles/pharmacological-management-of-attention-deficit-hyperactivity-disorder-in-adults.html
- UNSW Sydney. Half a million Australians are regularly using GLP-1 medicines: study. Jul 2026. At: www.unsw.edu.au/newsroom/news/2026/07/half-a-million-australians-regularly-use-GLP1-medicines-study
